About a year ago, I began evaluating how much my patients knew about their health issues and educating them accordingly. The experience has transformed the way I practice and I believe widespread use of this approach will transform healthcare. I heard an interview with Dr. Mehmet Oz in which he mentioned that the origin of the word doctor is the Latin word for teacher. I was taken aback. Thinking of myself as a teacher when interacting with patients was a new concept. After observing colleagues and deception of physicians in the media, I concluded that the concept also must be unfamiliar to other doctors and the public. Our general ineffectiveness as teachers is evident when talking with patients. I have encountered few individuals who understand their health conditions. Many are resigned to the “doctor knows best” mindset and blindly obey whatever recommendations they receive. Or worse, they believe doctors and the healthcare system are about making money and cheating them. They feel disempowered and lose interest in managing their care. This is a concerning trend — especially among the Medicaid/Medicare population in my area. Teachers clear up misconceptions Education has helped alleviate this. When reviewing medications, I ask patients if they know why they are taking them. It has been startling to see that the majority of individuals I see are unclear on or are completely unaware of the indication for most if not all of their medications. Many say they’ve been on these prescriptions for years. I help them understand why. During the discussion, I ascertain their knowledge of their conditions. My findings have been eye-opening. Most have misconceptions of what their diagnosis entails while others are clueless. We review the disease process and discuss how it relates to them. Unfortunately, not everyone is receptive, however most have listened at least briefly, which I believe has some merit. Many have said that they never received information about their diagnoses and, moreover, have never had someone elucidate the facts with them. It has also inspired quite a few to begin their own research and continue their self-education. Thankfully, I have the luxury of time for assessments and the benefit of interacting with patients in the familiar and comfortable environments of their home or workplace. However, I believe a shift in focus can make this available in any clinical setting. Building patient-doctor partnerships as teachers We should stop looking for ways to build Doctor-Patient relationships and instead start fostering and strengthening Patient-Doctor partnerships. We as physicians are serving our patients and providing them with our expertise to manage their health. However, it seems like many believe the opposite — either doctors are all-knowing and shouldn’t be challenged or questioned, or doctors are selfish, arrogant pill-pushers who can’t be trusted. I can’t blame people for believing either. If your interaction with physicians consisted of short visits with brief reviews of lab results, culminating in prescriptions for expensive medications, how would you feel? We can turn this around. By making time during office visits and hospital assessments to educate and have discussions with patients, we can create an environment where they feel included in their care — especially when the information is tailored to them and their unique situations. In addition, patients should be encouraged to independently review the presented information and return with questions as needed. This way, they are more likely to work with us to maintain or improve their health. We need to do more than distribute health materials or send patients to classes. We must routinize patient education in our practice to have a significant impact. Teachers create a positive feedback loop Teaching and self-education bolsters the patients’ experience as well as our own. Any of you who currently teach or have had the experience of lecturing or giving a talk can attest to this. Prior to the lecture or talk, we review as much background information on the topic as possible to prepare ourselves. This engrains knowledge and facts. The more we teach the topic and give the presentation, the more familiar we become with it. It also provides the opportunity to use the response and feedback of the students or audience to gauge our comprehension and ability to clearly and cohesively convey it. What if we all had the opportunity to review material and reinforce our familiarity each day we see patients? It shouldn’t take much time or effort. For instance, smartphones and computers give us access to apps, websites, videos, podcasts, e-books and audio books that can be referenced between patients, during lunch breaks or while commuting. I firmly believe the value in these practice investments will be the restoration of the intent of our profession and the formation of an alliance with our patients and the general public that will serve us all well into the future. Emeka Onyedika, MD, is a physician evaluator conducting in-home health evaluations. Source
